Sr. Claims Representative-Legal Construction Defect Specialist

AF Group; Los Angeles (CA); Hybrid; USD 80,000 - 136,000; Full time

Job summary

A leading insurance firm is seeking a Sr. Claims Representative specialized in legal construction defect claims. The role involves coverage analysis, collaboration with internal and external resources, and management of outside counsel. Ideal candidates will possess a relevant bachelor's degree and significant claims processing experience.

Qualifications

• Bachelor's degree in business administration, Finance, Risk Management, or similar.
• Minimum of 5 years experience processing Named Insured and Additional Insured CD claims.

Responsibilities

• Handle suits on third party litigated construction defect claims.
• Analyze coverage issues on litigated claims.
• Assist with negotiations, mediations, and arbitrations.

Skills

Investigation

Negotiation

Problem Solving

Communication

Education

Bachelor’s degree

JD degree

Tools

Microsoft Office

Job description

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SUMMARY
Primary responsibilities of a Litigation Specialist/Senior Claims Representative – Legal handling construction defect claims includes, but is not limited to: coverage analysis, collaboration with internal and external resources, management of outside counsel and resolution of claims in the best interest of our insureds.
Description
ESSENTIAL FUNCTIONS:
1. Handle suits on third party litigated construction defect claim files, including collaborating with and managing outside counsel as assigned.
2. Analyze coverage issues on litigated claim files and claim files with potential for litigation.
3. Assist with negotiations, mediations, arbitrations and settlement procedures as assigned.
4. Attend and provide litigation advice in claim review meetings.
5. Coordinate referral with AVP of Claims or VP of Claims on other litigated claims requests to outside counsel.
6. Conduct legal research as necessary on pending suit files and as requested by other departments.
7. Conduct audits of litigated claims files.
8. Review company policy forms as needed.
9. Research and write brief opinions on legal issues.
10. Recommend reserve and payment changes as necessary for the file.
11. Provide and report claims information to Senior Management on an as needed basis.
12. Assist Forms Committee; propose changes/revisions/amendments to company policy forms make appropriate policy language recommendations and draft policy language for new forms.
13. Must adhere to the company code of ethics.
14. Other duties as assigned by General Counsel, Sr. Claims Management or Executive Management.
15. Ability to interact with others in a professional manner.
16. Attendance.

KNOWLEDGE, SKILLS AND ABILITIES REQUIRED TO PERFORM ESSENTIAL FUNCTIONS:
1. A bachelor's degree in business administration, Finance, Risk Management, or similar. Equivalent education, experience, and skills may also qualify.
2. Experience adjusting construction claims for an insurance carrier or an attorney experienced in litigating construction disputes.
3. Superior investigation skills regarding coverage, facts, and risk transfer issues on each claim.
4. Ability to analyze coverage submissions and provide assistance.
5. Ability to document facts, actions and other claim relevant information in electronic claims file.
6. Ability to prioritize, organize and plan work for self and others.
7. Excellent customer service skills.
8. Excellent written and oral communication skills.
9. Superior problem-solving ability.
10. Thorough knowledge of claim procedures, policies, terminology, etc.
11. Computer proficient with Microsoft Office programs, such as Word, Excel and Outlook.
12. Possess a valid driver’s license and State adjusting license(s) as applicable.
13. Ensure assigned files are handled in good faith as defined by statute, case-law and corporate standards.
14. Ability to travel as required.
15. Sit, stand, walk/ambulatory.
16. Ability to lift 10 pounds.
This position can be staffed as a remote work-from-home position or in one of our claims offices (Scottsdale, AZ; Westerville, OH; or Overland Park, KS).
Qualifications:
Education
Required: Experience may be accepted in lieu of degree.
1. Bachelor’s degree or better.
2. JD degree a plus.
3. Insurance Industry Designations a plus.
Experience
Required: Minimum of 5 years related experience processing both Named Insured and Additional Insured CD claims.

PAY RANGE
Actual compensation decision relies on the consideration of internal equity, candidate’s skills and professional experience, geographic location, market, and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $80,900 and $135,400.

#AFG

Seniority level

• Seniority level

  Not Applicable

Employment type

• Employment type

  Full-time

Job function

• Job function

  Finance and Sales

• Industries

  Insurance

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